Exploring the Relationship Between Obesity, Weight Loss and Health-Related Quality of Life: An Updated Systematic Review of Reviews.

The aim of this systematic literature review (SLR) of reviews was to update the evidence, established in a 2017 SLR, on the impact of obesity and weight loss by various interventions on health-related quality of life (HRQoL). In total, eight SLRs and/or meta-analyses published since 2017 were identified. The results consistently demonstrated a negative association between obesity and HRQoL, with some evidence suggesting poorer HRQoL in people with adverse metabolic profiles. In addition to substantial weight or body mass index reduction, metabolic and bariatric surgery (MBS) or endoscopic bariatric therapies resulted in significant and clinically relevant HRQoL improvements, with pronounced and persistent effects on the physical components in particular. HRQoL typically improved within 1-2 years after MBS and stabilised or deteriorated while remaining above baseline in subsequent years, likely due to weight regain. Evidence for the benefits of exercise interventions on HRQoL was inconclusive. Notably, no SLRs on anti-obesity medications were identified, limiting conclusions on this emerging treatment area. This updated SLR expands on previous findings from the 2017 SLR, providing additional insights into underexplored areas, including the role of metabolic profiles in HRQoL and trends of HRQoL after MBS. Evidence synthesis remains challenging due to heterogeneity in HRQoL measurements used in this field.